UCF RESTORES and Department of Psychology, University of Central Florida.
Boston College, Boston, MA.
Psychiatry Res. 2020 Dec;294:113515. doi: 10.1016/j.psychres.2020.113515. Epub 2020 Oct 22.
Identifying predictors of suicide attempts is critical in intervention and prevention efforts, yet finding predictors has proven difficult due to the low base rate and underpowered statistical approaches. The objective of the current study was to use machine learning to examine predictors of suicidal behaviors among high-risk suicidal Soldiers who received outpatient mental health services in a randomized controlled trial of Brief Cognitive Behavioral Therapy for Suicide Prevention (BCBT) compared to treatment as usual (TAU). Self-report measures of clinical and demographic variables, administered prior to the start of outpatient treatment to 152 participants with recent suicidal thoughts and/or behaviors were analyzed using machine learning software to identify the best combination of variables for predicting suicide attempts during or after treatment. Worst-point suicidal ideation, history of multiple suicide attempts, treatment group (i.e., BCBT or TAU), suicidogenic cognitions, and male sex were found, in combination, correctly classified 30.8% of patients who attempted suicide during the two-year follow-up period. This combination has higher sensitivity than many models that have previously been used to predict suicidal behavior. Overall, this study provides a combination of variables that can be assessed clinical to help identify high-risk suicidal individuals.
识别自杀企图的预测因素对于干预和预防工作至关重要,但由于基础率低和统计方法的效力不足,寻找预测因素一直具有挑战性。本研究的目的是使用机器学习来检查在一项随机对照试验中接受简短认知行为治疗预防自杀 (BCBT) 与常规治疗 (TAU) 的高危自杀士兵中自杀行为的预测因素。对 152 名有近期自杀念头和/或行为的参与者进行了临床和人口统计学变量的自我报告测量,这些参与者在门诊治疗开始前进行了测量,然后使用机器学习软件分析这些变量,以确定用于预测治疗期间或之后自杀企图的最佳变量组合。最严重的自杀意念、多次自杀企图史、治疗组(即 BCBT 或 TAU)、自杀观念和男性性别,这些因素结合起来,正确分类了在两年随访期间自杀的 30.8%的患者。这种组合的敏感性高于以前用于预测自杀行为的许多模型。总的来说,这项研究提供了可以在临床上评估的变量组合,以帮助识别高风险的自杀个体。